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All happy now :D Finished meds and just had our second checkup and everything is healing well. Restarted kibble alongside wet food a couple of days ago as an experiment and Manix actually ate his kibble first! must have missed them and obviously he's managing them fine with the missing teeth. Pretty much the only issue left over from the operation is stitches that can get annoying if they get loose. Although they are dissolvable stitches, they will take about a month to disappear so the vet removed any loose ones while we were there. If any others get too annoying for Manix, we'll go back to have them removed too but hopefully there won't be a need. His confidence is mostly back too :) He just stood still without complaints while stitches were being removed and is more active now than he was before the operation - toothaches are gone :) I am starting brushing what is left tonight and we've made 6 monthly appointments for dental checks so hopefully we won't loose any more. Thanks again to everyone who has contributed, it really did help during our very difficult time :) Here's an interesting article I just ran into that explains why we freak out so much when they are unwell.

ok, i wouldn't have accepted this coming from any other vet but seems to be another tiny dog thing - he got a full checkup this morning, there are no health problems or real pain and he is recovering well from the surgery (he actually came to me with his ball in his mouth this morning wanting to play fetch). so the verdict was anxiety. we're going to see if he regains his confidence by next checkup in a weeks time and anti-anxiety meds if he is still scared then. also got a recommendation for a good 24/7 clinic and in case others are looking for one, he recommended CARE (http://carevetspecialists.com.au/category/care-vet-specialists/) as having a great team of vets. the breathing issue was identified as "reverse sneezing" caused by irritation to his nasal passages from the extractions and it is reducing in frequency, mainly just when he gets over-excited now. guess we can finally sleep easy tonight. thanks all :)

no disrespect meant, i just read "We can only advise based on what we read here, what we think, and how we think we would act in the same/similar situation". nevertheless, if this hasn't happened to any of your dogs after surgery, someone who actually had this problem could shine more light. there is also the too tiny issue with us too, you can see from some of the earlier posts in this thread that advice was mixed due to his size (2kg). and yes, they do tend to find the worse times to be unwell so a backup vet seems essential :/ I usually see one of the other vets at the practice if his vet is on holidays but they don't do after hours or sundays either Just realized my trusted vet would be right person to ask about this as he is well connected with other specialists! *facepalm* ok we'll find a trustworthy after hours vet tomorrow too. i've been thinking and observing a bit more and he might just be freaking out too, i've tried applying gentle pressure to any part of him that can be sore and still no pain reactions, he just seems comforted by all that. moving from his bed to my lap seems to have reduced the frequency of these yelps too. will be a long night but hopefully i'll learn what to do about it tomorrow. thanks for the well wishes :)

He had both. The procedure was done under general but they also gave him another for his gums (seemed to numb most of his face but he could walk around) and that's the one that took longer than expected, he recovered from the general as expected. mainly happens when he is resting and he is resting most of the time as instructed by his vet. just suddenly yelps out of nowhere, changes where he is resting and then seems fine till it happens again?! where he is resting makes no difference either. seems completely random. he is eating fine, has a good appetite but isn't very active. that part i'm not as worried about as he is actually banned from any strenuous activities for 2 weeks and the vet said it would take about that long for him to return to completely normal. if he's not back to terrorizing everyone after 2 weeks, then I would be worried about the lethargy. Fair enough, I was hoping to hear from someone who actually experienced this with their own dogs but any advice adds more information for decisionmaking so all is welcome. True, as above, I was really hoping for someone who had this experience so I can make an educated decision. There is nothing reassuring about going to a vet i don't know and trust. When it comes to serious health issues, we don't even see the other vets at the same practice, his vet was very carefully picked after much research. I guess it is about time I started researching for an equally trustworthy after hours vet as well. If anyone knows a reputable one around NE Melbourne, that would be helpful. I think I'll just stay up monitoring him tonight and make the decision based on whether it is getting better or worse. If it does get worse or more regular, i'll risk the 24/7, otherwise we'll be at his vet's door when he comes to work in the morning. Thanks to both for your responses, I'll keep one eye on Manix and one eye for further advice. The more opinions/recommendations I have, the easier it is to make these kind of decisions. I understand that some of you might be more trusting and see this as a "seeing a vet or not" situation but for me it is more a decision about seeing a possibly harmful vet or waiting a few more hours to see a vet i trust. Extra Info: I can actually massage his mouth and he finds that comforting and shows no signs of pain when i do that?! The randomness is what I am finding most strange

It has been 5 days and this pain only started last night (seems to be a correlation with his grogginess going away after the operation). I assume it is his mouth as he doesn't have any other injuries etc. but, he doesn't show any signs of that (rubbing his mouth etc) and seems puzzled about it himself. We'll definitely get a vet to look at this but I am just wondering if he'll be ok till tomorrow morning? I have lost another dog due to vet negligence at one of those 24/7 clinics so I'd like to avoid seeing them unless it is an emergency and I have no other options. His own vet (which i picked very carefully) is the preferred option but that will have to wait till tomorrow morning as they're closed on sunday. The pains are occasional and short lasting (then again, he might be hiding lesser pain the rest of the time) so I'm not sure if I should treat this as an emergency and go to a 24/7 or wait till tomorrow morning to see the vet we trust :/

ok, i guess happy will take a while :/ he is recovering well and i've been able to give him all his meds by hiding them in salmon (his favorite) so haven't had to force him to open his mouth except for 1 occasion a couple of days ago (by pushing against his health canines). in case anyone else searches for answers and finds this thread, whatever they gave him to numb his face lasted a lot longer than expected.i was starting to get worried about him not eating or drinking for that long but he managed to recover enough for those around 3-4am (brought him home at 6pm). everything else has been going well but starting last night, he seems to occasionally get sharp pains (he vocalises differently for those) for no apparent reason and then they go away as suddenly after a short time. My vet is closed today and i don't like taking my pets to those dodgy 24/7 clinics but if this requires immediate attention it is an option. I was just wondering if anyone has any ideas on whether this is expected and/or sign of some problems with the healing process? He was given a long lasting pain management injection after the operation and is now on anti inflammatories for pain management. we're also on antibiotics but i don't think that helps with pain (other than killing any remaining infection that might be causing pain). I am really worried about this as well but would prefer to take him to his own vet tomorrow unless it needs to be looked at more urgently? As usual, any advice would be much appreciated.

Thanks for the well wishes :) Happy to report that the operation went well, all our blood tests are fine and Manix is in my lap recovering from all the anesthetics (he got local and general). It is heartbreaking seeing him like this when he was happily playing yesterday but hopefully he'll return to his normal self soon and be even happier than before without the toothaches. We lost a lot of teeth but fortunately managed to save all his canines (one was expected to require extraction). We're also now armed with everything we can possibly use to prevent this in the future but it will be a couple of weeks before we start the new routines. We're just on puppy milk, wet food, anti-inflammatories and a round of antibiotics to wipe out any traces of the infection for now. i just hope the local wears off soon so i can try to give him the anti-inflammatories for tonight. Thinking about crushing the pill into some puppy milk as i'm sure he has had enough things shoved into his mouth today His tongue is still numb from the local so i'll give that a shot when he regains control of it. Hopefully, I'll be able to post some new pictures of a very happy Manix soon and thanks again to everyone here for their advice and concern, they really helped :)

ok, we've seen the senior vet and it is periodontal disease as bad as that is, it is much better than not having a clear cause and having my hands tied about preventing it in the future. fortunately, all the important teeth can be saved but he will lose quiet a few including pretty much all his incisors With his help, I am now more confident that I can prevent this problem from happening again (as well as daily checks from me, he'll be having his teeth checked by the vet every 6 months instead of 12 now) but today is a very scary and depressing day.. nothing for me to do at this point other than hope for a safe surgery. they didn't have a problem with me insisting that the operation is performed by that senior vet (specialist in small animal surgery) so hopefully we'll get through this safely. thanks again to everyone who contributed to the discussion. the advice i received here and other research made it much easier to understand the problem properly and have an educated discussion with the vet. i'll update once i get my baby back.

ok, this is where we can provide some feedback when we get there. the one thing i don't have to worry about with Manix is food (quantity wise) as he is not one of those dogs you can overfeed (unlike my previous dogs who just ate as much as i gave them so i had to watch their weight). He is more interested in play than food and only eats as much as he needs to (doesn't care that much about treats either). Not sure about chicken necks yet so i'll put that aside for now but we can experiment with both full wings and tips. It will be supervised until I am convinced it is safe so we'll give the topic scientific due diligence and report back :) This is a great discussion though as there aren't many for ridiculously tiny dogs (the pap thread seems dead these days). I am not sure if that term is used by breeders here but I wouldn't even call him a toy dog, he is a teacup. my previous dogs were a shih tzu and a maltese (both full size) and they were far less complicated to look after than Manix (except for weight management). He is unbelievably cute and his personality makes all the work worthwhile but i think i might pick a different breed when the time comes to get him a companion. He does seem to have a thing for shih tzus and mini poodles lol

thanks rascal, sounds like wingtips for manix once he recovers from the operation :) hopefully by switching to chicken wings (and starting brushing) we might be able to avoid this situation again. i'm also going to throw out any balls he can't fit in his mouth, the only explanation i can think of for the loose incisor is the way he carries them. i'm already very careful with him due to his size but it seems i need to be even more careful when it comes to his teeth. feeling a lot more confident about the operation now thanks to all of you and managed to book a pre-surgery visit to the senior vet. he is hard to get appointments for but managed to organize that with only a 1 day delay for the operation :) seeing the consensus here, i'm sure he'll suggest surgery too but at least i know he'll make a better effort to look for causes and get the right scans done. it is a bit late for the ones that have to come out now but the more i understand why this happens, the better our chances are in trying to stop him from losing any more.

This is why i get stressed about everything. Someone told me chiken bone splinters more easily and more dangerous as a result so I have never tried chicken bones. If they are actually safe (which i assume is the case if you've been doing this for a while and with multiple dogs), they would make a good alternative. Currently, if I am buying just for him, I get osso buco with the marrow rich bone, remove the meat and give him the meat cooked and the bone raw. If we're sharing, he gets (raw) rib bones; either from lamb chops or rib eye steak (i buy them with the bone on just for this purpose). Before I lost my other dog, lamb necks were also part of the routine as supposedly they are better at cleaning his canines but can't do that anymore as manix isn't strong enough to deal with them; my shih tzu used to strip the hard parts and leave manix all the sinew to clean his teeth with. he does need a bigger companion in his life again. Do you give the wing tips raw or cooked?

Thanks Rappie, great advice and I will definitely request the dental radiographs to be done now if they don't already have it planned. It is great to have another vet confirm everyone's opinions too :) It is still sad to see him lose his teeth but if that is what has to be done for him to be healthy and pain free, that is what will be done. I'll still try to see the senior vet (Dr Steve Pryor if you know him) before surgery as there has been cases in the past with my previous dogs where he found operations suggested by other vets as unnecessary (and offered alternative treatments that worked) whereas the vet i have seen this time seems to start every sentence with "lets operate" regardless of the problem. Also, when my last dog got cancer, Dr Pryor sent samples to many cancer specialists in australia before deciding on treatment while others wanted to just jump in and operate without that information. Needless to say, I have a lot more trust in his decisions. Thank you again for your input :)

Thanks for the new responses, i feel much more comfortable about the extractions now :) I have had dogs all my life but never had a dog that had this problem. I also never had loose teeth myself so had no idea they aren't treatable (there seems to be some options for humans but they sound pretty traumatic for a small dog). But, I have also never had a dog this small either. I don't know if the breeder could tell he would end up half sized (supposed to be a reputable breeder I found here and Manix' papers show that he comes from a long line of full size pure-breeds) but he is my kid now so that is kind of irrelevant. In a way I am sort of hoping they will find a little bit of infection (vet couldn't tell as the gums seem healthy from the outside) as that seems treatable to prevent future tooth loss whereas teeth getting loose for no reason is harder to understand and safeguard against. yes, he will be losing one incisor (the tooth with no plaque at all) but the other 2 are the last premolars (some plaque on those). i can guess the incisor might be due to the way he carries larger balls (by hooking his teeth to loose material on the ball - usually with his canines but sometimes he does use his incisors for it) so I might make the bigger and heavier balls disappear. but, unless they are infected, i have no idea why the premolars got loose (although the suggestion by Dr Christine Hawke as recommended by Ness that it might be due to crunching too hard on bones makes some sense so i might stop giving him bones and find him softer things to chew on). i also need to pay more attention to how the vet looks at the back teeth, his mouth is tiny so I find it near impossible to inspect the ones right at the back (can reach with my finger though so we should be ok to brush them after manix recovers from surgery). with puppy teeth, it was his canines; the puppy ones were like tiny fishbones so the adult ones couldn't push them out and had the risk of coming out crooked. From what I can remember, I think he was around 6 months when we did that. Can general anesthetic stunt his growth? bit late now but why he only grew to half size is another mystery; adult male paps are suppose to be 4-4.5 kg, manix is 2 kg and the vet says that is the health weight for him (right amount of muscle and fat for his frame). I am starting to understand why i don't see that many paps around, they have brilliant personalities but the whole being very tiny thing isn't helping with health issues :/

Thanks cavNrott, i'll add him to Manix' health list. If we have further dental issues, I will want to take him to a specialist. However there seems to be an agreement in the responses I am getting here that if they are loose, they can't be saved and they need to come out. I'll still consult the senior vet just to see what he has to say about all this but it sounds like i shouldn't cancel the operation and create delays with that. Thank you all again for all your responses. I still need to look into what might have caused this but at least I feel a lot more confident about the decision to have them extracted being the right one.

Thanks GrufLife and showdog, those help towards the most important aspect of my question; whether there is a non-magical way to fix them. I know that if I go to my dentist with a problem tooth, he will try everything possible to save that tooth but sometimes they do have to come out as a last resort. I am simply worried that the vet might be skipping that "try everything possible to save that tooth" part and jumping to last resort. With the kibble, I am feeding him 2 types, one designed for small dogs and one for larger dogs (someone told me that the bigger ones might be more effective) and they both claim to be designed to keep his teeth clean..and he knows he has to finish them all. We also use a water additive that is also supposed to help with his teeth. Since we ended up this situation regardless, I guess brushing is mandatory from now on. That is brilliant Ness, thank you very much! I am not sure about trying another practice as the senior vet at mine is considered one of the best small animal surgeons in Australia, I just didn't specify last time as we were just going in for vaccinations and ended up seeing one of the other vets there who I don't trust as much. Dr Christine Hawke is a great lead though, I'll be contacting her as well but I just checked her site and there was a plausible explanation as to why we might be in this situation; bones! I always thought they were good for his teeth so he does get them but considering how tiny he is, maybe trying to chew on them is putting too much strain on his teeth as she suggests. Lack of any explanations as to why this has happened is the most disturbing part for me; if i don't know what caused the problem, how can i prevent him from losing more next year? The biggest irony is that we had to extract some of his puppy teeth because they wouldn't fall off naturally and now we need to extract the ones that are supposed to stay in Thanks to all again for your advice :)